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Homeowner Assistance Programs Application Urban Redevelopment Authority of Pittsburgh Page 1 URA Center for Housing Opportunities 2020 Home Repair Assistance Application The Urban Redevelopment Authority of Pittsburgh (URA) offers a variety of programs to help homeowners and renters make necessary repairs and upgrades in order to stay in their homes. For your convenience, you only need to fill out this application for all of your home repair needs . Once you submit your application, we will review it and determine eligibility for any of our programs. Below is a summary of the different programs and terms we offer. Homeowner Assistance Program (HAP): Assist with home repairs and upgrades Limit: $30,000 Terms: $5,000 as a grant; $25,000 as a 0% Interest 30-year deferred loan Home Accessibility Program for Independence (HAPI): Assist with accessibility modifications Limit: $10,000 for homeowners; $5,000 for Landlords Term: Grant Homeowner Assistance Program Plus (HAP+): Assist with home repairs (50%-80% AMI) Limit: $30,000 Term: $5,000 as a grant; Up to $12,500 as a 0% interest 30-year deferred loan; $12,500 as a 0% interest 20-year amortizing loan. 2020 Pittsburgh Area Median Income (AMI) Household Size 30% 50% 80% 1 $17,450 $29,050 $46,500 2 $19,950 $33,200 $53,150 3 $22,450 $37,350 $59,800 4 $26,200 $41,500 $66,400 5 $30,680 $44,850 $71,750 6 $35,160 $48,150 $77,050 The URA is here to help you. If you have questions or need help completing an application, please call us and we will be happy to help you complete your application. 412-255-6574

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Page 1: URA Center for Housing Opportunities 2020 Home Repair ... · Urban Redevelopment Authority of Pittsburgh Page 1 URA Center for Housing Opportunities 2020 Home Repair Assistance Application

Homeowner Assistance Programs Application Urban Redevelopment Authority of Pittsburgh Page 1

URA Center for Housing Opportunities

2020 Home Repair Assistance Application

The Urban Redevelopment Authority of Pittsburgh (URA) offers a variety of programs to help

homeowners and renters make necessary repairs and upgrades in order to stay in their homes.

For your convenience, you only need to fill out this application for all of your home repair needs.

Once you submit your application, we will review it and determine eligibility for any of our

programs.

Below is a summary of the different programs and terms we offer.

Homeowner Assistance Program (HAP): Assist with home repairs and upgrades

Limit: $30,000

Terms: $5,000 as a grant; $25,000 as a 0% Interest 30-year deferred loan

Home Accessibility Program for Independence (HAPI): Assist with accessibility modifications

Limit: $10,000 for homeowners; $5,000 for Landlords

Term: Grant

Homeowner Assistance Program Plus (HAP+): Assist with home repairs (50%-80% AMI)

Limit: $30,000

Term: $5,000 as a grant; Up to $12,500 as a 0% interest 30-year deferred loan; $12,500 as a 0%

interest 20-year amortizing loan.

2020 Pittsburgh Area Median Income (AMI)

Household Size 30% 50% 80%

1 $17,450 $29,050 $46,500 2 $19,950 $33,200 $53,150 3 $22,450 $37,350 $59,800 4 $26,200 $41,500 $66,400 5 $30,680 $44,850 $71,750 6 $35,160 $48,150 $77,050

The URA is here to help you.

If you have questions or need help completing an application, please call us

and we will be happy to help you complete your application.

412-255-6574

Page 2: URA Center for Housing Opportunities 2020 Home Repair ... · Urban Redevelopment Authority of Pittsburgh Page 1 URA Center for Housing Opportunities 2020 Home Repair Assistance Application

Homeowner Assistance Programs Application Urban Redevelopment Authority of Pittsburgh Page 2

Home Repair Assistance Application

Return this application to:

Urban Redevelopment Authority of Pittsburgh

Lending and Investments Unit, Housing Lending

412 Boulevard of the Allies, Suite 901

Pittsburgh, PA 15219

IMPORTANT: To qualify for assistance and financing, you will need to obtain and furnish the following

documents as well:

Verification of Income/Employment; Copy of latest tax return

Property and Loan Information

Subject Property Address (Street, City, State, ZIP)

Purpose of Grant/Loan (check all that apply)

☐ General Improvement Repairs (HAP) ☐ City Code Violation Repairs (HAP)

☐ Energy Efficiency Upgrades (HAP) ☐ Accessibility Modifications (HAPI)

☐ Emergency Repairs (Water heater, furnace, roof, sewer lines) (HAP)

☐ Other:

Describe the repairs/modifications that are needed, to the best of your knowledge:

Title of the Property

Is the title of the property in the name of the Applicant? ☐ Yes ☐ No (Renting) ☐ No (explain below)

Number of Units Currently Live in the Property? ☐ Yes ☐ No

Any Known City Code Violations? ☐ Yes ☐ No

How did you hear about our programs?

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Homeowner Assistance Programs Application Urban Redevelopment Authority of Pittsburgh Page 3

Personal Information

IMPORTANT: You must supply income information and documentation for all household members.

If you are applying for a loan that you and another person will benefit from and are relying on income and assets

from yourself and another person(s), complete information under both Applicant 1 and Applicant 2.

First Name

Applicant 1 Applicant 2

Middle Initial

Last Name

Birth Date

Marital Status ☐Married ☐ Unmarried ☐Separated

☐ Widowed

☐Married ☐ Unmarried ☐Separated

☐ Widowed

Veteran? ☐No ☐ Yes ☐No ☐ Yes

Current Address (Street, City, State, Zip)

☐ Same as Applicant 1

Years There

Rent/Own ☐ Own ☐ Rent ☐ Own ☐ Rent If less than 2 years:

Previous Address

☐ Same as Applicant 1

Phone No.

Email Address

Household Size

Household Members Relation to Applicant 1 Age

Self

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Homeowner Assistance Programs Application Urban Redevelopment Authority of Pittsburgh Page 4

Employment Information

Fill out if you are employed (If not employed, skip to “Income Information” section)

Provide employment information for the past 2 years

Name & Address of Employer

Applicant 1 Applicant 2

☐ Self Employed

☐ Self Employed

Dates of Employment

Position/Title

Business Phone

Name & Address of Employer

Applicant 1 Applicant 2

☐ Self Employed

☐ Self Employed

Dates of Employment

Position/Title

Business Phone

Name & Address of Employer

Applicant 1 Applicant 2

☐ Self Employed

☐ Self Employed

Dates of Employment

Position/Title

Business Phone

Income Information

List all income in the household (including children)

Income sources include: employment, social security, disability, pension, TANF cash, child support

Gross Monthly Income List income source

Applicant 1 Applicant 2 Child Name:

Child Name:

Total

$ $ $ $ $

$ $ $ $ $

$ $ $ $ $

$ $ $ $ $

$ $ $ $ $

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Homeowner Assistance Programs Application Urban Redevelopment Authority of Pittsburgh Page 5

INFORMATION FOR GOVERNMENT MONITORING PURPOSES The following information is requested by the federal government of certain types of loans related to a dwelling in order to

monitor the lender’s compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not

required to furnish this information, but are encouraged to do so. You may select one or more designations for – “Race”. The law

provides that a lender may not discriminate on the basis of this information, or on whether you choose to furnish it. However, if

you choose not to furnish the information and you have made this application in person, under federal regulations the lender is

required to note ethnicity, race, and sex on the basis of visual observation or surname.

If you do not wish to furnish the information, please check below.

APPLICANT: CO-APPLICANT: __ I do not wish to furnish this information __ I do not wish to furnish this information Ethnicity: Ethnicity: □ Hispanic or Latino □ Hispanic or Latino □ Not Hispanic or Latino □ Not Hispanic or Latino Race: Race: □ American Indian or Alaska Native □ American Indian or Alaska Native □ Asian □ Asian □ Black or African American □ Black or African American □ Native Hawaiian or Other Pacific Islander □ Native Hawaiian or Other Pacific Islander □ White □ White Sex: Sex: □ Female □ Female □ Male □ Male

Area Median Income (AMI):

☐ Under 30%

☐ Under 50%

☐ Under 80%

☐ Above 80%

Total Gross Annual Income $

Total members in Household

URA Staff Only

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Homeowner Assistance Programs Application Urban Redevelopment Authority of Pittsburgh Page 6

HAP PLUS Supplemental Application

HAP PLUS is for homeowners between 51% - 80% AMI (see chart on first page)

If you are below 51% AMI, proceed to the next page

Assets

Applicant 1 Applicant 2

Checking Account

Name and Address of Bank

☐ Same as Applicant 1

Account No.

Balance

Savings Account

Name and Address of Bank

☐ Same as Applicant 1

Account No.

Balance

Home Mortgage ☐ Check here if you have no mortgage

Name and Address of Bank

☐ Same as Applicant 1

Original Mortgage Amount

Unpaid Balance

Monthly Payment

Car(s) Owned ☐ Check here if you have no cars

Year and Make Financed By Account No. Unpaid Balance Monthly Payment

NOTICE TO HAP+ APPLICANTS Due to federal regulations, we must submit your project for review by other state and local agencies, who may

mandate that we address any lead-based paint, historical and preservation efforts, and/or activities outside of the

original scope of work. These required activities will be disclosed and presented to you prior to signing agreements

and work commencing. These costs will be taken from your total eligible loan/grant amounts.

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Homeowner Assistance Programs Application Urban Redevelopment Authority of Pittsburgh Page 7

HAP PLUS Only

Installment Debts Show all Banks, Credit Unions, National Credit Cards and Finance Companies from which you have borrowed or which you are authorized to use.

Creditor - Address and Account No. Original Amount Unpaid Balance Monthly Payment

Everything that I have stated in this application is correct to the best of my knowledge. I understand that

the URA will retain this application whether or not it is approved. The Urban Redevelopment Authority is

authorized to check my credit score and employment history and to discuss any questions about my

credit experiences.

Applicant 1 Signature: Applicant 2 Signature:

___________________________ _________________________________

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Homeowner Assistance Programs Application Urban Redevelopment Authority of Pittsburgh Page 8

Important – Please Read

MORTGAGE APPLICATION DISCLOSURE (REAL ESTATE SECURED LOANS ONLY)

This loan will be secured by a mortgage or a deed of trust. You acknowledge that this property will not be used for any

illegal or restricted purpose.

FALSE STATEMENT

Please be on notice that it may be a federal crime to knowingly make any false statements concerning this loan application.

I/We certify that the information provided in this application is true and correct as of the date set forth opposite my/our

signatures below.

___________________________________________ Date: ____/____/____

Borrower’s Signature

___________________________________________ Date: ____/____/____

Co- Borrower’s Signature

NOTICE REGARDING INSPECTIONS

URA may inspect your property before and during construction. The inspections are performed

solely to protect URA’s loan funds. URA does not warrant the value of the property. URA does not warrant

or guaranteed that its inspection will reveal everything that may be wrong with your property. URA does

not warrant materials or workmanship. If you want to satisfy yourself that the condition of the property

does not require other work or that the work done by the contractor is done correctly, you must, at your

own expense, obtain your own home inspector.

ACKNOWLEDGEMENT

I have read and understood the foregoing Notice to Borrower

__________________________

Applicant Witness

Date: _________________

__________________________

Co-Applicant Witness

Date: _________________

(A witness cannot be anyone applying for this loan)

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Homeowner Assistance Programs Application Urban Redevelopment Authority of Pittsburgh Page 9

NOTIFICATION

Watch Out for Lead-Based Paint Poisoning

Source of Lead Based Paint

The interiors of older homes and apartments

often have layers of lead-based paint on the

walls, ceilings, windowsills, doors and

doorframes. Lead-based paint and primers

may also have been used on outside porches,

railings, garages, fire escapes and

lampposts. When the paint chips flakes or

peels off there may be a real danger for

babies and young children. Children may

eat paint chips or chew on painted railings,

windowsills or other items when parents are

not around. Children can also ingest lead

even if they do not specifically eat paint

chips. For examples, when children play in

an area where there are loose paint chips or

dust particles containing lead, they may get

these particles on their hands, put their hands

into their mounts, and ingest a dangerous

amount of lead.

Hazards of Lead-Based Paint

Lead poisoning is dangerous – especially to

children under the age of seven (7). It can

eventually case mental retardation,

blindness and even death.

Symptoms of Lead-Based Paint

Poisoning

Has your child been especially cranky or

irritable? Is he or she eating normally?

Does your child have stomachaches and

vomiting? Does he or she complain about

headaches? Is your child unwilling to play?

These may be signs of lead poisoning. Many

times though, there are no symptoms. This

does not mean that you should not be

concerned if you believe your child has been

exposed to lead-based paint.

Advisability and Availability of Blood

Lead Level Screening

If you suspect that your child has eaten chips

of paint or someone told you this, you should

take your child to the doctor or clinic for

testing. If the test shows that your child has

an elevated blood lead level, treatment is

available. Contract your doctor or local

heath department for help or more

information. Lead screening and treatment

are available through the Medical Program

for those who are eligible. If your child is

identified as having an elevated blood lead

level, you should immediately notify the

Community Development or other agency to

which you or your landlord is applying for

rehabilitation assistance so the necessary

steps can be taken to test your unit for lead-

based paint hazards. If your unit does have

lead-based paint, you may be eligible for

assistance to abate that hazard.

Precautions to Take to Prevent Lead-

Based Paint Poisoning.

You can avoid lead-based paint poisoning by

performing some preventive maintenance.

Look at your walls, ceilings, doors,

doorframes and windowsills. Are there

places where the paint is peeling, flaking,

chipping, or powdering? If so, there are

some things you can do immediately to

protect your child:

Cover all furniture and appliances;

Get a broom or stiff brush and remove all

loose pieces or paint from walls, woodwork,

window wells, and ceilings;

Sweep up all pieces of paint and plaster and

put them in a paper bag or wrap them in

newspaper. Put these packages in the

trashcan. DO NOT BURN THEM;

Do not leave paint chips on the floor in

window wells, Damp mop floors and

windowsills in and around the work area to

remove all dust and paint particles. Keeping

these areas clear of paint chips, dust and dirt

is easy and very important; and

Do not allow loose paint to remain within

your children’s reach since children may

pick loose paint off the lower part of the

walls.

Homeowner Maintenance & Treatment of

Lead-Based Paint Hazards

As a homeowner, you should take the

necessary steps to keep your home in good

shape. Water leaks from faulty plumping,

defective roofs and exterior holes or breaks

may admit rain and dampness into the

interior of your home. These conditions

damage walls and ceilings and cause paint to

peel crack or flake. These conditions should

be corrected immediately. Before repainting

all surfaces that are peeling, cracking,

chipping or loose should be thoroughly

cleaned by scraping or brushing the loose

paint from the surface, then repainted with

two (2) coats for non-leaded paint. Instead of

scraping and repainting the surface may be

covered with other materials such as

wallboard, gypsum, or paneling. Beware that

then lead-base paint is removed by the

scraping or sanding, a dust is created, which

may be hazardous. The dust can enter the

body either by breathing it or swallowing it.

The use of heat or paint removers could

create a vapor or fume which may cause

poisoning if inhaled over a long period of

time. Whenever possible, the removal of

lead-based paint should take places when

there are not children or pregnant women on

the premises. Simply painting over defective

lead-base paint surfaces does not eliminate

the hazard. Remember that you as an adult

play a major role in the prevention of lead

poisoning. Your actions and awareness

about the lead problem can makes a big

difference.

Tenant and Homebuyer Responsibilities:

You should immediately notify the

management office of the agency through

which you are purchasing your home if the

unit has flaking, chipping, powdering or

peeling paint, water leaks from plumbing or

a defective roof. You should cooperate with

the office’s effort to repair the unit.

If the property was constructed before 1978, there is a possibility of lead-based paint.

Please read the following information concerning lead-based paint poisoning.

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Homeowner Assistance Programs Application Urban Redevelopment Authority of Pittsburgh Page 10

CONFLICT OF INTEREST DISCLOSURE

All applicants for the Urban Redevelopment Authority (URA) loan programs are required to disclose

if they are employees of or are related to employees of the URA or the City of Pittsburgh. If you are

a URA or City of Pittsburgh employee or are related to a URA or City of Pittsburgh employee, the

URA must obtain a conflict of interest waiver from its Board of Directors.

Applicant’s Name: ________________________________________________________

Please indicate the following condition that applies:

☐ I am not an employee of and am not related to an employee of the URA or the City of Pittsburgh

☐ I am an employee of the URA.

☐ I am an employee of the City of Pittsburgh. ______________ Department

☐ I am related to an employee of the URA. ___________________ (Name)

☐ I am related to an employee of the City of Pittsburgh. __________________(Name)

Please indicate the relationship: Spouse, Mother, Father, Daughter, Son, Other, ________

I acknowledge and agree that any misrepresentation contained in this Conflict of Interest

Disclosure may result in the cancellation of my loan application or, if the misrepresentation is

discovered after the loan is made, I may be required to repay the loan in full on demand.

Applicant’s Signature: ________________________ Date: ______________

Co-Applicant’s Signature: ______________________ Date: ______________

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Homeowner Assistance Programs Application Urban Redevelopment Authority of Pittsburgh Page 11

CONFIDENTIALITY WAIVER

In order to provide you the best service and coordination, the Urban Redevelopment Authority

(URA) may need to discuss your application and information with other parties including, but

not limited to, banks and lenders, settlement company, landlord, contractors, and contracted

service providers.

The extent to which information is shared will be limited to only the information necessary to

coordinate with others and your private information will be kept confidential, unless it is

required to coordinate and approve services and assistance.

By signing below, you give the Urban Redevelopment Authority (URA) permission to share your

information with our partners in order to deliver the best service to you and your household.

___________________________________ _______________

Applicant’s Signature (Applicant 1) Date

____________________________________ ________________

Co-Applicant’s Signature (Applicant 2) Date

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Homeowner Assistance Programs Application Urban Redevelopment Authority of Pittsburgh Page 12

PHOTOGRAHY AND VIDEO RECORDING AUTHORIZATION AND RELEASE FORM

The undersigned authorizes the Urban Redevelopment Authority of Pittsburgh (the “URA”) and its

representatives to take photographs and video recordings of the property located at

_____________________________________, Pittsburgh, PA (the “Property”) which is owned by the

undersigned and is being renovated using URA funds. In addition, the undersigned releases to the URA

and its representatives all rights of any kind to such photographs and video recordings of the Property

without payment or any other consideration to the undersigned. The undersigned understands that

such photographs and video recordings may be edited, copied, exhibited, published, or distributed

without the undersigned’s inspection or approval. The undersigned represents and warrants that the

undersigned is authorized to release these rights.

Such photographs and video recordings may be used for URA promotional purposes and may be

displayed in any print, visual, or electronic media including, but not limited to, social media, websites,

advertisements, newsletters, newspapers, magazines, application documents, and other promotional

materials. The undersigned hereby releases the URA and its representatives from any liability in

connection with the taking, recording, digitizing, or use of such photographs and video recordings as

described above.

The undersigned has the right to revoke this authorization at any time by notifying the URA in writing.

The revocation will not affect any actions taken before the receipt of such written notification.

By signing this form, the undersigned acknowledges that he/she/they completely read and fully

understand(s) the above authorization and release and agree to be bound thereby.

Applicant’s Signature: _________________________ Date: ______________

Applicant’s Name: ____________________________